This work is distributed by the COMMUNITY HEALTH RESEARCH UNIT University of Ottawa. CHRU Publication No. M04-2
|
|
- Linette Bishop
- 6 years ago
- Views:
Transcription
1 This work is distributed by the COMMUNITY HEALTH RESEARCH UNIT University of Ottawa CHRU Publication No. M04-2 EVALUATION OF NURSING BEST PRACTICE GUIDELINES: ORGANIZATIONAL CHARACTERISTICS Nancy Edwards, R.N., Ph.D 1 Barbara Davies, R.N., Ph.D 2 Evangeline Danseco, Ph.D 2 Denyse Pharand, R.N., Ph.D 2 Lucie Brosseau, Ph.D 3 Jenny Ploeg, RN, Ph.D 4 Viren Bharti, Ph.D 1 March Community Health Research Unit, Department of Epidemiology and Community Medicine, University of Ottawa 2 School of Nursing, University of Ottawa 3 School of Rehabilitation Sciences, University of Ottawa 4 School of Nursing, McMaster University Community Health Research Unit University of Ottawa Department of Epidemiology and Community Medicine 451 Smyth Road, Ottawa, Ontario, Canada K1H 8M5 Tel: (613) ext Fax: (613) nedwards@uottawa.ca
2 Acknowledgments This monograph was based on an evaluation project awarded to Nancy Edwards and Barbara Davies by the Registered Nurses Association of Ontario and funded by the Ministry of Health and Long-Term Care. The authors would like to acknowledge Tazim Virani and the RNAO staff as well as the contributions of the other members of the evaluation team and project staff. Evaluation Team Co-investigators Maureen Dobbins, RN, PhD Jennifer Skelly, RN, PhD McMaster University Pat Griffin, RN, PhD Office of Nursing Policy, Health Canada Evaluation Project Staff Barbara Helliwell Marilyn Kuhn Elana Ptack Cindy Hunt Mandy Fisher CHRU Monograph Series i
3 Disclaimer The opinions expressed in this publication are those of the authors. Publication does not imply any endorsement of these views by either of the participating partners of the CHRU or the Registered Nurses Association of Ontario. Copyright 2004 by the CHRU Printed in Ottawa, Ontario, Canada All rights reserved. Reproduction, in whole or in part, of this document without the acknowledgement of the authors and copyright holder is prohibited. The recommended citation is: Edwards N., Davies B., Danseco E., Pharand D, Brosseau L., Ploeg J. & Bharti V. (2004). Evaluation of Nursing Best Practice Guidelines:. CHRU Monograph Series ii
4 TABLE OF CONTENTS Introduction... 1 Development of the Scales... 2 Background... 2 Best Practice Guideline Development... 3 Evaluation design... 4 Description of the Sample... 5 Statistical Procedures Used in Psychometric Testing of Scale Items... 9 Descriptive Statistics Missing Data Results of Factor Analysis Administration, Scoring and Interpretation Administering the Scales Scoring and Interpretation Conclusions References Appendices Primer on Factor Analysis Resources Perceived Characteristics of Innovating (PCI) for BPG Implementation Organizational Stability Organizational Support for Best Practice Guidelines Pre-Implementation Organizational Support for Best Practice Guidelines Post-Implementation Organizational Culture for Change CHRU Monograph Series iii
5 Evaluation of Nursing Best Practice Guidelines: Introduction In 1999, the Registered Nurses Association of Ontario (RNAO), with funding from the Ontario Ministry of Health and Long-Term Care, launched a multi-year project aimed at developing, pilot testing, evaluating and disseminating best practice guidelines (BPGs) for nurses. Seventeen BPGs were developed and launched by the RNAO during three cycles. Each BPG includes substantive, evidence-based recommendations for nursing practice and for organizational and policy change, as well as recommendations for nursing education. Details about the RNAO Best Practice Guideline Project may be obtained on the RNAO web site: A multi-site team designed a pre-post design evaluation to examine the process and impact of pilot site implementation of the BPGs. Both generic indicators and indicators specific to the BPGs were developed. This monograph is one of a series describing the measures used during this evaluation. The monograph is intended for evaluation teams that may be interested in using or adapting the interview schedules for their own evaluation purposes. In this monograph, we describe the development and psychometric properties of scales that measure organizational characteristics and provide recommendations for the administration, scoring and interpretation of these scales. The evaluation measures on organizational characteristics included in this monograph are: 1) Perceived Characteristics of Innovating for BPG Implementation, 2) Organizational Stability, 3) Organizational Support for BPG Implementation and 4) Organizational Culture for Change. The scales are included in the appendix. CHRU Monograph Series 1
6 Development of the Scales Background Two sets of instruments are described in this monograph: a) those used to measure organizational characteristics that were expected to influence the adoption of the Best Practice Guidelines and b) an instrument to assess the innovation characteristics of Best Practice Guidelines. In this section, instruments that were developed by the team are described. For those instruments that were adapted from the literature, the original sources for the instruments, the psychometric characteristics of the original versions of the instruments and the adaptations we made to existing instruments are summarized. Innovation characteristics The original Perceived Characteristics of Innovating (PCI) instrument included 43 items and 8 subscales (Moore & Benbasat, 1991), with a shortened version of 25 items. The PCI was designed to investigate how perceptions affect individual s actual use of technology based on Rogers' diffusion theory (1995). Domains of the original PCI included: 1) relative advantage (the degree to which the innovation is perceived as being better than its precursor); 2) compatibility (the degree to which the innovation is perceived as being consistent with the existing values, needs, and past experiences of the user); 3) complexity or ease of use (the degree to which the innovation is perceived as being difficult to use); 4) results demonstrability (the extent to which the uses of the innovation are apparent); 5) trialability (the degree to which the uses of the innovation may be experimented with before adoption); 6) voluntariness of use (the degree to which the use of the innovation is perceived as being voluntary); 7) image (the degree to which use of an innovation is perceived to enhance one's image or status in one's social system); and, 8) observability (the degree to which the results of an innovation are observable to others). The Cronbach s coefficient alphas for the original PCI subscales ranged from.71 (trialability) to.93 (relative advantage) (Moore & Benbasat, 1991). Construct validity of the original tool was confirmed via factor analysis and discriminant analysis of "adopters" versus non-adopters." We selected items from the first four scales of the short version of the PCI, with a view towards selecting those that were relevant for BPG implementation. Eight of the original PCI items were adapted for use in this study. Two new items were added which asked respondents to assess the extent to which the BPG fit with standard unit policies and procedures (unit compatibility). CHRU Monograph Series 2
7 Organizational characteristics Three domains of organizational characteristics were assessed: organizational stability, organizational culture for change, and organizational support for BPG implementation. The 7-item organizational stability instrument assessed significant organizational change that was expected to impact on implementation of the BPGs. For example, respondents are asked to rate on a 5-point scale to what extent staff cuts, absenteeism or hiring of new staff have occurred in their organization within the past six months. The organizational culture for change instrument assessed aspects of the organization that can influence changes in the organization such as morale, communication and workload. The degree of perceived organizational support for BPG implementation was assessed using five items from the support/resistance subscale of the Implementation Attitude Questionnaire developed by Schultz & Slevin, (1975). This measure was originally designed to assess the extent to which the respondent perceived adequate support from the organization in the implementation of a new information innovation (Robey, 1979; Robey & Bakr, 1978; Robey & Zeller, 1978; Rodriguez, 1977). Using a sample of salespeople being introduced to a computer-based information system, Robey (1979) reported acceptable internal consistency of the support/resistance scale (Cronbach s alpha =.74). This study also found a significant relationship between organizational support/resistance and objective measures of system use (r =.31, p <.01). In a more recent study of on-line learning for public health professionals, acceptable levels of internal consistency were found for organizational support for Best Practice Guidelines (Cronbach s alpha =.74) (Lockett, Edwards, Gurd & Simpson, 2003). Best Practice Guideline Development The RNAO developed BPGs during three cycles (see Figure 1). A multidisciplinary panel of nurses, administrators, nursing researchers, and specialists used a systematic approach to develop the best practice guidelines. Briefly, this process involved the review of evidence from current research, theory, and expert advice as well as extensive reviews of similar clinical practice guidelines. Recommendations were selected and the level of evidence supporting each recommendation was identified. Recommendations based on studies with meta-analyses were assigned the rating for the highest level of evidence while recommendations based on expert consensus opinion, in the absence of evidence from quasi-experimental studies were assigned the rating for the lowest level of evidence. Preliminary guideline recommendations and supporting documentation were then reviewed by several stakeholders. Each published BPG presents the guideline development process in detail and the specific stakeholders CHRU Monograph Series 3
8 who reviewed the guidelines. Upon completion of each cycle of guidelines, the RNAO invited health care organizations in Ontario to submit proposals outlining an implementation strategy. Successful organizations were provided with financial and administrative support for implementing the BPG. Figure 1. Development of RNAO Best Practice Guidelines Cycle 1 Fall Prevention Promoting Continence Preventing Constipation Risk Assessment of Pressure Ulcers Cycle 2 Enhancing Healthy Adolescence Client Centered Care Crisis Intervention Assessment and Management of Pain Establishing Therapeutic Relationships Prevention and Management of Pressure Ulcers Strengthening/ Supporting Families Cycle 3 Adult Asthma Control Breastfeeding Screening for Delirium, Dementia and Depression Reducing Foot Complications for People with Diabetes Smoking Cessation Venous Leg Ulcers Evaluation design Evaluation of the BPGs implementation in these organizations proceeded along the three cycles. Specific objectives of the evaluation of BPG pilot site implementation were to: Document the process of BPG implementation across project sites from the perspective of clinical resource nurses, staff nurses and nursing administrators; Determine the effectiveness of BPG implementation on changes in nursing practice, and selected clinical outcomes; Determine perceived utility and value of the BPG by clinical resource nurses, staff nurses and administrators; and, Examine factors that influence implementation of the BPG. Both qualitative and quantitative methods were used in the evaluation. A before and after design was used for cycles 2 and 3 evaluation, and a retrospective baseline for CHRU Monograph Series 4
9 cycle 1. Patient chart audits, patient interviews and nurse interviews were conducted at baseline and 6 months after implementation. For those BPGs where patient interviews were conducted or chart audits completed, patient eligibility criteria were set for each of the BPGs. A more detailed description of the evaluation design is available from the authors. Description of the Sample The sociodemographic characteristics of the sample of staff who completed the scales is shown in Table 1. The majority of respondents were registered nurses. However, in several organizations, registered practical nurses or staff from other disciplines were also involved in BPG implementation and thus were included in the sampling frame. A total of 747 participants are included in this analysis. Absent from this summary are those who participated in the evaluation of the Venous Leg Ulcers BPG and the Diabetes Foot Care BPG. Post-implementation data for the pilot site evaluations of these BPGs were not yet available at the time of this report. CHRU Monograph Series 5
10 Table 1. Demographic Characteristics of the Sample Demographic Characteristics Evaluation of Nursing Best Practice Guidelines: Cycle Cycle 1 Cycle 2 Cycle 3 Group Total N % N % N % N % Gender Female Male Missing Group Total Highest Education Diploma Canadian Nurse s Association Certification Baccalaureate Degree Masters degree Doctorate Other Missing Group Total Years Employed in Nursing > Missing Group Total Professional Licence RN RPN Other Missing Group Total Employment Status Full time Part time Casual Missing Group Total Current Position Staff nurse Team leader Other Missing CHRU Monograph Series 6
11 Demographic Characteristics Cycle Cycle 1 Cycle 2 Cycle 3 Group Total N % N % N % N % Group Total Years on Unit > Missing Group Total Average Number of Patients Less than Missing Group Total Typical shift worked Days Evenings Nights Combination Missing Group Total Years in agency > Missing Group Total Professional Activities Member of quality control committee in past year Member of research committee in past year Assisted with policy/procedure/ guideline/standard development in past year Presented research paper in past year CHRU Monograph Series 7
12 Demographic Characteristics Cycle Cycle 1 Cycle 2 Cycle 3 Group Total BPG N % N % N % N % Fall Prevention Promoting Continence Risk Assessment of Pressure Ulcers Client-Centred Care Establishing Therapeutic Relationships Prevention of Pressure Ulcers Crisis Intervention Assessment and Management of Pain Enhancing Healthy Adolescence Strengthening/ Supporting Families Adult Asthma Control Breastfeeding Smoking Cessation Screening for Delirium, Dementia and Depression Group Total Observation Period Completed only preimplementation Completed only postimplementation Completed pre- and postimplementation Group Total 194* ** * Note that for cycle 1, baseline information was gathered retrospectively. ** For cycle 3, only those respondents with pre and post are shown here and included in this analysis. CHRU Monograph Series 8
13 Statistical Procedures Used in Psychometric Testing of Scale Items Data were analyzed using SAS 8.02 software ([SAS/STAT] software, version [8] of the SAS system for Windows. copyright by SAS Institute Inc., Cary, N.C., USA). For each scale, descriptive analyses were conducted to examine response patterns, skewness and kurtosis of the data. Internal reliability was assessed using Cronbach s coefficient alpha. Principal component analysis was used to describe the main axes of variance. We then conducted a factor analysis to determine whether all items in the scale (or sub-scale) loaded on the factor. Orthogonal rotation procedures were used to obtain the maximal amount of variance for all scales in this monograph except for the scale on Organizational Culture for Change. Varimax rotation, the most commonly used type of orthogonal rotation, provides a simple structure in factor analysis and was used in this study to facilitate interpretation of the factors. The goal of the factor analysis was to determine how many factors the items were located under as well as their significance. A more detailed description of factor analysis is included in the appendix. For the present study, we used the following measurement criteria and cut-offs: 1. Sampling Adequacy: Sampling adequacy predicts if the data is likely to factor. This is measured by the Kaisar-Meyer-Olkin (KMO) statistic. We used the most common cut-off, i.e..60 for the present study. When the value was less than the cut-off, we analyzed sampling adequacy by cycles, and included data from cycles where sampling adequacy criterion was met. 2. Factor Loading: An acceptance threshold of.40 for the loading was used in this study. 3. Eigenvalue: The eigenvalue for a given factor measures the variance in all the variables that is accounted for by that factor. The ratio of eigenvalues is the ratio of explanatory importance of the factors with respect to the variables. Kaisar s criterion is a common rule of thumb for dropping the least important factors from the analysis. The Kaisar rule is to drop all components with eigenvalues less than 1.0 which is the default in the SAS software and hence our cut-off criterion. 4. Cronbach Coefficient Alpha: This statistic was used to evaluate the internal consistency of each factor, and of all items in each scale. It is a measure of squared correlation between observed scores and true scores. The higher the alpha, the more reliable the factor. A Cronbach's alpha of.70 (rounded off) is generally considered adequate. CHRU Monograph Series 9
14 Psychometric Properties of the Scales Evaluation of Nursing Best Practice Guidelines: Descriptive Statistics Table 2 shows the timing of administration, what cycles were included in the analysis, the total number of respondents and the number of respondents with complete data for each of the scales. For example, the PCI for BPG Implementation was administered six months after implementation (post-implementation). The data for this scale included all three cycles since the versions used in all cycles were identical. Of the 601 respondents with post-implementation data, only 473 had complete data (that is, no blanks for all ten items administered during post-implementation). Table 3 (see the following page) presents the descriptive statistics for each item of the scales, including skewness and kurtosis. Table 2. Sources of Data for Scales Scale Timing of Administration Perceived Characteristics of Innovating for BPG Implementation Cycles Included in Analysis Total Respondents N Respondents with Complete Data N (%) Post 1, 2 and (78/7%) Organizational Stability Post 1, 2 and (74.5%) Organizational Support for BPG Pre-Implementation Organizational Support for BPG Post-Implementation Organizational Culture for Change Pre 1, 2 and (87.2%) Post 2 and (85.3%) Pre 1, 2 and (79.2%) CHRU Monograph Series 10
15 Table 3. Descriptive Statistics Scales with Items N Range Mean Standard Deviation Skewness Kurtosis Perceived Characteristics of Innovating for BPG Implementation Using the RNAO best practice guideline has improved the quality of patient care I provide 514 1, The RNAO best practice guideline has been advantageous for my job 515 1, The RNAO best practice guideline is compatible with my daily practice 512 1, Results of using the RNAO best practice guideline are apparent to me 506 1, I can explain why using the RNAO best practice guideline is beneficial for nurses on our unit 511 1, The RNAO best practice guideline is useful to my work 512 1, It has been easy to implement the RNAO best practice guideline 507 1, Standard unit policies/procedures have fit well with the RNAO best practice guideline 501 1, Unit and/or agency policies/procedures have been modified to reflect the RNAO best practice guideline 495 1, The RNAO best practice guideline is too complicated for use by staff nurses* 513 1, PCI (Overall) 473 1, Organizational Stability Financial pressures (constraints or cutbacks) 481 1, Staff cuts 488 1, High staff turnover 490 1, Infusion of new money into organization 461 1, High staff absenteeism 489 1, Hiring of new staff 490 1, Increasing percentage of casual nurses 486 1, Organizational Stability (Overall) 448 1, CHRU Monograph Series 11
16 Scales with Items N Range Mean Standard Deviation Skewness Kurtosis Organizational Support for BPG Pre-Implementation Top management will support staff to implement best practice guidelines 635 1, Nurses would readily adopt changes required to implement best practice guidelines 632 1, Nurses will be given sufficient time and training to learn how to use best practice guidelines 630 1, We have adequate numbers of qualified staff to implement the best practice guidelines 631 1, We have the equipment and supplies needed to implement the best practice guidelines 613 1, Organizational Support for BPG Pre-Implementation (Overall) 591 1, Organizational Support for BPG Post-Implementation Top management has supported staff to implement RNAO best practice guidelines 358 1, Nurses have readily adopted changes required to implement the RNAO best practice guidelines 361 1, Nurses were given sufficient time and training to learn how to use best practice guidelines 361 1, We had adequate numbers of qualified staff to implement the RNAO best practice guidelines 359 1, We had the equipment and supplies needed to implement the best practice guidelines 357 1, Organizational Support for BPG Post-Implementation (Overall) 348 1, Organizational Culture for Change Nurses are open to new ways of doing things on my unit/team 643 1, The morale of nurses on my 642 1, CHRU Monograph Series 12
17 Scales with Items N Range Mean Standard Deviation Skewness Kurtosis unit/team is high Nurses exert group pressure on non-conforming workers 611 1, During unit meetings, there is a feeling of let's get things done 625 1, There is good communication between nurses and administration in my hospital/agency 632 1, Managers are strong advocates for nursing in my hospital/agency 625 1, Nurses carry out patient care procedures utilizing professional judgement to meet individual patient needs even when this means deviating from hospital/unit procedure 595 1, On my unit, nurses often participate in decision-making around patient care 642 1, On my unit, nurses often feel that they have too many patients to care for adequately* 630 1, Nurses on my unit are strong advocates for patients and families 642 1, Organizational Culture for Change (Overall) 537 1, * These items were reverse coded. Missing Data As illustrated in the table above, non-response rates for individual items on the scales ranged from a low of 5.3% to a high of 23.2%. The item with the lowest missing data was "the morale of nurses in my unit/team is high" in the Organizational Culture for Change scale. The item with the highest non-response rate was the item "infusion of new money into organization" of the Organizational Stability scale. Results of Factor Analysis Results of the factor analysis for each of the scales in this monograph are presented below. Table 4 presents the final factor solutions. All factors demonstrated good internal consistency (Cronbach's alpha ranged from.69 to.89). For the Perceived Characteristics for Innovating for BPG Implementation, 10 items were initially included in the analysis with a two-factor solution. Nine items loaded on one CHRU Monograph Series 13
18 factor, and only one item loaded on the second factor. This item ( the BPG is too complicated to use by staff nurses ) had a loading of 0.91 on a second factor. This item was dropped since it was a single item factor and appeared to measure a different dimension. A two-factor solution was obtained for the scale on Organizational Stability. One-factor solutions were obtained for the pre and post-test versions of the Organizational Support for BPG Implementation. A three-factor solution was obtained for the initial 10 items of the Organizational Culture for Change. The third factor was a single-item factor and was dropped ( nurses exert group pressure on non-conforming workers": loading =.74). The three items in the second factor were dropped due to low internal consistency (Cronbach's alpha =.42). The items in this second factor were: "nurses carry out patient care procedures utilizing professional judgment" (loading =.62), "on my unit nurses often participate in decisionmaking" (loading =.61), and "nurses on my unit are strong advocates for patients and families" (loading =.49). The final scale has six items loading on one factor. Table 4. Results of Factor Analysis on Scale Items loading Factor characteristics Perceived Characteristics of Innovating for BPG Eigenvalue = 5.03 Implementation.82 n=473 Cronbach's alpha (10 items) =.85 Sampling Adequacy (for factor) =.90 Factor 1 The RNAO best practice guideline has been advantageous for my job Using the RNAO best practice guideline has improved the quality of patient care I provide Results of using the RNAO best practice guideline are apparent to me I can explain why using the RNAO best practice guideline is beneficial for nurses on our unit The RNAO best practice guideline is useful to my work The RNAO best practice guideline is compatible with my daily practice Unit and/or agency policies/procedures have been modified to reflect the RNAO best practice guideline Standard unit policies/procedures have fit well with the RNAO best practice guideline It has been easy to implement the RNAO best practice guideline Cronbach's alpha =.89 Variance explained (%) = 50.3 CHRU Monograph Series 14
19 Scale Items loading Factor characteristics Organizational Stability Factor 1 n=448 Cronbach's alpha (all items) =.81 Sampling Adequacy (for factor)=.80 Hiring of new staff.87 High staff turnover.78 Increasing percentage of casual nurses.69 High staff absenteeism.59 Factor 2 Staff cuts.86 Financial pressures.82 Infusion of new money into organization.55 Eigenvalue = 3.30 Cronbach's alpha =.79 Variance explained (%) = 47.1 Eigenvalue = 1.10 Cronbach's alpha =.69 Variance explained (%) = 15.7 Organizational Support for Factor 1 BPG Implementation (Pre) Nurses will be given sufficient time and training to learn how to use best practice n = 591 guidelines Sampling Adequacy (for factor) = 0.75 Organizational Support for BPG Implementation (Post) n = 348 Sampling Adequacy (for factor)=.85 Top management will support staff to implement best practice guidelines We have adequate numbers of qualified staff to implement the best practice guidelines Nurses would readily adopt changes required to implement best practice guidelines We have the equipment and supplies needed to implement the best practice guidelines Factor 1 We had adequate numbers of qualified staff to implement the best practice guidelines Nurses were given sufficient time and training to learn how to use the best practice guidelines We had the equipment and supplies needed to implement the best practice guidelines Nurses have readily adopted changes required to implement the best practice guidelines Top management has support staff to implement the best practice guidelines Eigenvalue = 2.18 Cronbach's alpha =.67 Variance explained (%) = Eigenvalue = 3.02 Cronbach's alpha =.84 Variance explained (%) = 60.5 CHRU Monograph Series 15
20 Scale Items loading Factor characteristics Organizational Culture for Factor 1 Change n = 537 There is good communication between nurses and administration in my.76 hospital/agency Eigenvalue = 3.22 Cronbach's alpha =.78 Cronbach's alpha (10 items) =.70 Sampling Adequacy (for factor)=.79 The morale of nurses on my unit/team is high Managers are strong advocates for nursing in my hospital/agency During unit meetings there is a feeling of "let's get things done" Nurses are open to new ways of doing things on my unit/team On my unit/team nurses often feel that they have too many patients/clients to care for adequately Variance explained (%) = 32.2 CHRU Monograph Series 16
21 Administration, Scoring and Interpretation Evaluation of Nursing Best Practice Guidelines: Administering the Scales The scales in this monograph are to be given to nurses directly involved in the implementation of the nursing BPG. These scales were not designed for patients or clients' significant others. Table 5 below lists the scales, the number of items per scale (proposed based on factor analysis), the types of rating scale used, approximate time to complete them, and suggested timing of administration. Note that for the scale on Organizational Support for BPG Implementation, there is a pre-test version and a separate post-test version. Table 5. Description of Scales on Scale Number of Items Type of Rating Approximate Time for Pre or Post Administration Perceived Characteristics of Innovating for BPG Implementation Organizational Stability Organizational Support for BPG Implementation Organizational Support for Change Scale 9 items 4 point Likert scale 7 items 5 point Likert scale 5 items 4 point Likert scale 6 items 4 point Likert scale Completion 3 min Post 2 min Post 2 min Pre and Post (different versions) 2 min Pre The scales were designed to be self-administered. It is recommended that nurses finish the scales in one session, or at the very least one scale in one sitting. If these scales are part of a larger battery of evaluation measures, adequate time and minimizing fatigue on the part of the respondents should be considered. For the evaluation of the pilot site implementation, it was found that time available and workload were barriers adversely affecting response rates. CHRU Monograph Series 17
22 Respondents should be provided with a covering letter explaining the purpose of the scales, the time required for completing the scales, and the confidentiality of the information. Scoring and Interpretation The scoring procedure for the scales involves adding the ratings for each item and obtaining a mean total score for each scale. If there are items left blank, cases either need to be excluded or missing values imputed before calculating the mean total score across all respondents. Negatively worded items are reverse-coded so that scores are in the same direction. In general, higher scores indicate higher levels of the indicator being measured. For the scale on Organizational Stability, higher scores indicate lower organizational stability. Conclusions Evaluation is a key step in determining whether the implementation of a nursing best practice guideline has improved patient outcomes through changes in nursing care. Evaluation findings may guide decisions about whether or not to support efforts to sustain or expand the use of specific practice guidelines in an organization. The scales in this monograph included: 1) Perceived Characteristics of Innovating for BPG Implementation, 2) Organizational Stability, 3) Organizational Support for BPG Implementation and 4) Organizational Culture for Change. Scores from these scales can provide insights on factors that can influence the implementation of the BPGs. This monograph presents the development and psychometric properties of these scales based on our pilot site evaluation of the implementation of BPGs from cycles 1 to 3. Scales included in this monograph demonstrated adequate levels of internal consistency. Scales demonstrated adequate response variability. Missing response patterns suggest that respondents were least familiar with items listed in the Organizational Stability scale. Scales are recommended for use in similar evaluation studies. CHRU Monograph Series 18
23 References Evaluation of Nursing Best Practice Guidelines: Lockett, D., Edwards, N., Gurd, G., Simpson, J. (2003). On-line learning for public health professionals: Timely or overdue? Community Health Research Unit Monograph M03-03, Moore, G.C., Benbasat, I. (1991). Development of an instrument to measure the perceptions of adopting an information technology innovation. Information Systems Research, 2(3), Robey, D. (1979). User attitudes and management information system use. Academy of Management Journal, 22(3), Robey, D., Bakr, M.M. (1978). Task redesign: individual moderating and novelty effects. Human Relations, 39(8), Robey, D., Zeller, R.F. (1978). Factors affecting the success and failure of an information system for product quality. Interface 8(2), Rodriguez, J. I. (1977). The design and evaluation of a strategic issue competitive information system [Doctoral Dissertation]. US: University of Pittsburgh. Rogers, E.M. (1995). Diffusion of innovations (4th edition). New York: The Free Press. Schultz, R.L., Slevin, D.P. (1975). Implementation and organizational validity: An empirical investigation. In: Schultz, R.L., Slevin, D.P. (Eds.), Implementing operations research/management science (pp ). New York: American Elsevier. CHRU Monograph Series 19
24 Appendices A Primer on Factor Analysis Resources Perceived Characteristics of Innovation Organizational Stability Organizational Support for BPG Pre-Implementation Organizational Support for BPG Post-Implementation Organizational Culture for Change CHRU Monograph Series 20
25 Primer on Factor Analysis Factor analysis is a technique used mainly to reduce the number of variables, and to detect structure in the relationship between variables. Factor analysis is commonly used in developing and refining instruments, by identifying how many factors or domains a questionnaire has, and which items go together i.e., the items have high loadings on a factor. A typical factor analysis answers four major questions: 1. How many factors are needed to identify the pattern of relationship among given variables? 2. What is the nature of those factors? 3. How well do the inferred factors explain the variables they define? 4. How much unique variance is explained by the observed variables? 1. Sampling Adequacy: Sampling adequacy predicts if the data is likely to factor. This is measured by the Kaisar-Meyer-Olkin (KMO) statistic. This value ranges from 0 to 1.0 and a value of at least.60 should be obtained to proceed with the factor analysis. 2. Factor Loading: This is purely arbitrary and varies by research context. In instruments with Likert type scales, the following criteria are often used: low loading for less than.40, moderate between.40 and.60, and high for more than.60. Factor loadings range from -1 to +1. The sign reflects the direction of relationship between the item and the factor. 3. Eigenvalue: The eigenvalue for a given factor measures the variance in all the variables that is accounted for by that factor. The ratio of eigenvalues is the ratio of explanatory importance of the factors with respect to the variables. Kaisar s criterion is a common rule of thumb for dropping the least important factors from the analysis. The Kaisar rule is to drop all components with an eigenvalue less than 1.0 which is the default in the SAS software. 4. Rotation: Rotation is commonly used to obtain a simple and more understandable factor structure. There are generally two types of rotation: orthogonal and oblique rotation. Orthogonal rotation is commonly used since it facilitates interpretation. An orthogonal rotation provides a simpler factor structure and assumes that the factors are uncorrelated. Varimax rotation is the most widely used orthogonal rotation. Oblique rotation is used when factors are correlated factor structure and interpretation of the factors is often more complex. CHRU Monograph Series 21
26 Resources For information on the Registered Nurses Association of Ontario (RNAO) Best Practice Guidelines Project, consult the website of the RNAO. The nursing BPGs can be downloaded for free.hard copies are available for purchase. For further information on developing, implementing and evaluating nursing practice guidelines, consult the RNAO Toolkit: Implementation of clinical practice guidelines. The RNAO Toolkit can also be downloaded for free and hard copies are available for purchase through the RNAO website. For more information on evaluation measures for nursing best practice guidelines, the Community Health Research Unit (CHRU) of the University of Ottawa is publishing a series of monographs that can be downloaded for free. Hard copies may also be purchased (see website address below). These monographs include measures on organizational innovation characteristics, organizational stability, organizational culture for change, organizational support for BPG implementation, education and supportive processes, and perceived worth of the BPG, and interviewing nurses and administrators. Community Health Research Unit University of Ottawa 451 Smyth Road Ottawa, ON K1H 8M5 CHRU Monograph Series 22
27 Perceived Characteristics of Innovating (PCI) for BPG Implementation Post-Implementation The following items are designed to measure how people feel about new innovations. Please indicate the extent to which you agree or disagree with each of the following statements, concerning your experiences with the RNAO best practice guideline on implemented on your unit. There are no right or wrong answers. We are interested in your opinions. Please circle your response. Strongly Disagree Disagree Agree Strongly Agree 1. Using the RNAO best practice guideline has improved the quality of patient care I provide. 2. The RNAO best practice guideline has been advantageous for my job. 3. The RNAO best practice guideline is compatible with my daily practice. 4. Results of using the RNAO best practice guideline are apparent to me. 5. I can explain why using the RNAO best practice guideline is beneficial for nurses on our unit. 6. The RNAO best practice guideline is useful to my work. 7. It has been easy to implement the RNAO best practice guideline. 8. Standard unit policies/procedures have fit well with the RNAO best practice guideline. 9. Unit and/or agency policies/procedures have been modified to reflect the RNAO best practice guideline. Edwards N., Davies B., Danseco E., Pharand D., Brosseau L., Ploeg J., Bharti V., (2004). Evaluation of Nursing Best Practice Guidelines:.
28 Organizational Stability Post-Implementation Listed below are examples of organizational changes that may influence RNAO best practice guidelines regarding implementation. For each item, indicate to what extent this change has taken place in your organization over the past six months. Please circle your response. 1. Financial pressures (constraints or cutbacks) Not at Somewhat To a large all extent 5 2. Staff cuts 5 3. High staff turnover 5 4. Infusion of new money into organization 5 5. High staff absenteeism 5 6. Hiring of new staff 5 7. Increasing percentage of casual nurses 5 Edwards N., Davies B., Danseco E., Pharand D., Brosseau L., Ploeg J., Bharti V., (2004). Evaluation of Nursing Best Practice Guidelines:.
29 Organizational Support for Best Practice Guidelines Pre- Implementation The following items concern how supportive you feel your organization will be in facilitating the implementation of best practices guidelines (BPGs). Using the response categories provided, please indicate the extent to which you agree or disagree with each of the following statements. There are no right or wrong answers. We are interested in your opinions. 1. Top management will support staff to implement best practice guidelines. 2. Nurses would readily adopt changes required to implement best practice guidelines. 3. Nurses will be given sufficient time and training to learn how to use best practice guidelines. 4. We have adequate numbers of qualified staff to implement the best practice guidelines. 5. We have the equipment and supplies needed to implement the best practice guidelines. Strongly Disagree Disagree Agree Strongly Agree Edwards N., Davies B., Danseco E., Pharand D., Brosseau L., Ploeg J., Bharti V., (2004). Evaluation of Nursing Best Practice Guidelines:.
30 Organizational Support for Best Practice Guidelines Post- Implementation The following items concern how supportive you feel your organization will be in facilitating the implementation of the RNAO best practice guidelines. Using the response categories provided, please indicate the extent to which you agree or disagree with each of the following statements. There are no right or wrong answers. We are interested in your opinions. Please circle your response. Strongly Disagree Disagree Agree Strongly Agree 1. Top management has supported staff to implement the RNAO best practice guidelines. 2. Nurses have readily adopted changes required to implement the RNAO best practice guidelines. 3. Nurses were given sufficient time and training to learn how to use best practice guidelines. 4. We had adequate numbers of qualified staff to implement the RNAO best practice guideline. 5. We have the equipment & supplies needed to implement the best practice guideline. Edwards N., Davies B., Danseco E., Pharand D., Brosseau L., Ploeg J., Bharti V., (2004). Evaluation of Nursing Best Practice Guidelines:.
31 Organizational Culture for Change Pre-Implementation Evaluation of Nursing Best Practice Guidelines: The following items are designed to measure aspects of your organization s culture. Using the response categories provided, please indicate the extent to which you agree or disagree with each of the following statements. Strongly Disagree Disagree Agree Strongly Agree 1. Nurses are open to new ways of doing things on my unit/team. 2. The morale of nurses on my unit/team is high. 3. During unit meetings, there is a feeling of let s get things done. 4. There is good communication between nurses and administration in my hospital/agency. 5. Managers are strong advocates for nursing in my hospital/agency. 6. On my unit/team, nurses often feel that they have too many patients/clients to care for adequately. Edwards N., Davies B., Danseco E., Pharand D., Brosseau L., Ploeg J., Bharti V., (2004). Evaluation of Nursing Best Practice Guidelines:.
This work is distributed by the COMMUNITY HEALTH RESEARCH UNIT University of Ottawa. CHRU Publication No. M04-1
This work is distributed by the COMMUNITY HEALTH RESEARCH UNIT University of Ottawa CHRU Publication No. M04-1 EVALUATION OF NURSING BEST PRACTICE GUIDELINES: INTERVIEWING NURSES AND ADMINISTRATORS Nancy
More informationNURSING BEST PRACTICE GUIDELINES EVALUATION USER GUIDE
Restraint Prevalence Tools NURSING BEST PRACTICE GUIDELINES EVALUATION USER GUIDE November 2006 Disclaimer The opinions expressed in this publication are those of the authors. Publication does not imply
More informationThe attitude of nurses towards inpatient aggression in psychiatric care Jansen, Gradus
University of Groningen The attitude of nurses towards inpatient aggression in psychiatric care Jansen, Gradus IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you
More informationAmany A. Abdrbo, RN, MSN, PhD C. Christine A. Hudak, RN, PhD Mary K. Anthony, RN, PhD
Information Systems Use Among Ohio Registered Nurses: Testing Validity and Reliability of Nursing Informatics Measurements Amany A. Abdrbo, RN, MSN, PhD C. Christine A. Hudak, RN, PhD Mary K. Anthony,
More informationRNAO International Affairs and Best Practice Guidelines Program
RNAO International Affairs and Best Practice Guidelines Program Dr. Doris Grinspun, RN, MSN, PhD, LLD(hon), O.ONT Chief Executive Officer Dr. Irmajean Bajnok, RN, MScN, PhD Director, RNAO International
More informationBarriers & Incentives to Obtaining a Bachelor of Science Degree in Nursing
Southern Adventist Univeristy KnowledgeExchange@Southern Graduate Research Projects Nursing 4-2011 Barriers & Incentives to Obtaining a Bachelor of Science Degree in Nursing Tiffany Boring Brianna Burnette
More informationCOF WEBINAR 6 AUGUST 29, 2013 HOSTED BY THE REGISTERED NURSES ASSOCIATION OF ONTARIO
EVALUATING NURSING AND CLIENT OUTCOMES THROUGH GUIDELINE-BASED INDICATORS: THE RNAO NQUIRE INITIATIVE COF WEBINAR 6 AUGUST 29, 2013 HOSTED BY THE REGISTERED NURSES ASSOCIATION OF ONTARIO Welcome from Dr.
More informationMeasuring healthcare service quality in a private hospital in a developing country by tools of Victorian patient satisfaction monitor
ORIGINAL ARTICLE Measuring healthcare service quality in a private hospital in a developing country by tools of Victorian patient satisfaction monitor Si Dung Chu 1,2, Tan Sin Khong 2,3 1 Vietnam National
More informationJOURNAL OF INTERNATIONAL ACADEMIC RESEARCH FOR MULTIDISCIPLINARY Impact Factor 3.114, ISSN: , Volume 5, Issue 5, June 2017
VIRTUAL BUSINESS INCUBATORS IN SAUDI ARABIA ALAAALFATTOUH* OTHMAN ALSALLOUM** *Master Student, Dept. Of Management Information Systems, College of Business Administration, King Saud University, Riyadh,
More informationPerceived Barriers to Research Utilization Among Registered Nurses in an Urban Hospital in Jamaica
The Henderson Repository is a free resource of the Honor Society of Nursing, Sigma Theta Tau International. It is dedicated to the dissemination of nursing research, researchrelated, and evidence-based
More informationINPATIENT SURVEY PSYCHOMETRICS
INPATIENT SURVEY PSYCHOMETRICS One of the hallmarks of Press Ganey s surveys is their scientific basis: our products incorporate the best characteristics of survey design. Our surveys are developed by
More informationRelationships Between Nurses Empathy and Adult Attachment, Self-Esteem, and Communication Self-Efficacy
, pp.66-71 http://dx.doi.org/10.14257/astl.2015.104.15 Relationships Between Nurses Empathy and Adult, Self-Esteem, and Communication Self-Efficacy Sung Hee Lee 1, Su Jeong Song 2 1, College of Nursing
More informationEffect of DNP & MSN Evidence-Based Practice (EBP) Courses on Nursing Students Use of EBP
Effect of DNP & MSN Evidence-Based Practice (EBP) Courses on Nursing Students Use of EBP Richard Watters, PhD, RN Elizabeth R Moore PhD, RN Kenneth A. Wallston PhD Page 1 Disclosures Conflict of interest
More informationEmployers are essential partners in monitoring the practice
Innovation Canadian Nursing Supervisors Perceptions of Monitoring Discipline Orders: Opportunities for Regulator- Employer Collaboration Farah Ismail, MScN, LLB, RN, FRE, and Sean P. Clarke, PhD, RN, FAAN
More informationA comparison of two measures of hospital foodservice satisfaction
Australian Health Review [Vol 26 No 1] 2003 A comparison of two measures of hospital foodservice satisfaction OLIVIA WRIGHT, SANDRA CAPRA AND JUDITH ALIAKBARI Olivia Wright is a PhD Scholar in Nutrition
More informationDetermining the Effects of Past Negative Experiences Involving Patient Care
Online Journal of Health Ethics Volume 10 Issue 1 Article 3 Determining the Effects of Past Negative Experiences Involving Patient Care Jennifer L. Brown PhD Columbus State University, brown_jennifer2@columbusstate.edu
More informationKathryn J. Dolan, Ph.D. & Kevin E. Kalinowski, Ph.D. Texas College of Osteopathic Medicine & Center for Learning and Development
Kathryn J. Dolan, Ph.D. & Kevin E. Kalinowski, Ph.D. Texas College of Osteopathic Medicine & Center for Learning and Development Osteopathic pre-clinical students participate in a variety of interprofessional
More informationEVIDENCED BASED PRACTICE
Using Evidence Based Practice: The Relationship Between Work Environment, Nursing Leadership and Nurses at the Beside Presented by Yvette M. Pryse RN, PhDc This research study was partially supported by
More informationNURSES PROFESSIONAL SELF- IMAGE: THE DEVELOPMENT OF A SCORE. Joumana S. Yeretzian, M.S. Rima Sassine Kazan, inf. Ph.D Claire Zablit, inf.
NURSES PROFESSIONAL SELF- IMAGE: THE DEVELOPMENT OF A SCORE Joumana S. Yeretzian, M.S. Rima Sassine Kazan, inf. Ph.D Claire Zablit, inf. DEA, MBA JSY QDET2 2016 2 Professional Self-Concept the way in which
More informationDevelopment and validation of an online questionnaire (PERoPA-M)
Development and validation of an online questionnaire (PERoPA-M) An international online survey on patient and visitor aggression in healthcare organizations from the nurse managers' perspective. This
More informationCommunity Pharmacists Attitudes Toward an Expanded Class of Nonprescription Drugs
Community Pharmacists Attitudes Toward an Expanded Class of Nonprescription Drugs Ruchit Shah 1 Erin Holmes 1 Donna West-Strum 1 Amit Patel 1,2 1 Department of Pharmacy Administration, The University of
More informationOriginal Article Rural generalist nurses perceptions of the effectiveness of their therapeutic interventions for patients with mental illness
Blackwell Science, LtdOxford, UKAJRAustralian Journal of Rural Health1038-52822005 National Rural Health Alliance Inc. August 2005134205213Original ArticleRURAL NURSES and CARING FOR MENTALLY ILL CLIENTSC.
More informationTitle Student and Registered Nursing Staff's Perceptions of 12- Hour Clinical Rotations in an Undergraduate Baccalaureate Nursing Program
The Henderson Repository is a free resource of the Honor Society of Nursing, Sigma Theta Tau International. It is dedicated to the dissemination of nursing research, researchrelated, and evidence-based
More informationExecutive Summary. This Project
Executive Summary The Health Care Financing Administration (HCFA) has had a long-term commitment to work towards implementation of a per-episode prospective payment approach for Medicare home health services,
More informationTitle: The Parent Support and Training Practice Protocol - Validation of the Scoring Tool and Establishing Statewide Baseline Fidelity
Title: The Parent Support and Training Practice Protocol - Validation of the Scoring Tool and Establishing Statewide Baseline Fidelity Sharah Davis-Groves, LMSW, Project Manager; Kathy Byrnes, M.A., LMSW,
More informationDevelopment and Testing of Quality Work Environments for Nursing
Development and Testing of Quality Work Environments for Nursing Principal Investigator Linda McGillis Hall, RN, PhD Co-investigators Diane Doran, RN, PhD Souraya Sidani, RN, PhD Leah Pink, RN, BScN, MN
More informationResearch-Competencies Assessment Instrument for Nurses (R-CAIN): A preliminary psychometric analysis
Research-Competencies Assessment Instrument for Nurses (R-CAIN): A preliminary psychometric analysis Anastasia Mallidou, RN, PhD Assistant Professor School of Nursing, University of Victoria Research team:
More informationThe significance of staffing and work environment for quality of care and. the recruitment and retention of care workers. Perspectives from the Swiss
The significance of staffing and work environment for quality of care and the recruitment and retention of care workers. Perspectives from the Swiss Nursing Homes Human Resources Project (SHURP) Inauguraldissertation
More informationResearch Brief IUPUI Staff Survey. June 2000 Indiana University-Purdue University Indianapolis Vol. 7, No. 1
Research Brief 1999 IUPUI Staff Survey June 2000 Indiana University-Purdue University Indianapolis Vol. 7, No. 1 Introduction This edition of Research Brief summarizes the results of the second IUPUI Staff
More informationUniversity of Massachusetts-Dartmouth College of Nursing. Final Project Report, July 31, 2015
University of Massachusetts-Dartmouth College of Nursing Final Project Report, July 31, 2015 Project Title: Establishing preliminary psychometric analysis of a new instrument: Nurse Competency Assessment
More informationThe Reliability of the Turkish Version of the Stressors in Students Scale
International Journal of Caring Sciences September-December 2017 Volume 10 Issue 3 Page 1360 Original Article The Reliability of the Turkish Version of the Stressors in Students Scale Ayse Demiray, PhD
More informationImpact of Exposure to Verbal Abuse on Nursing Students Emotional Labor and Clinical Practice Stress During Clinical Training
, pp.255-264 http://dx.doi.org/10.14257/ijbsbt.2015.7.4.25 Impact of Exposure to Verbal Abuse on Nursing Students Emotional Labor and Clinical Practice Stress During Clinical Training Hae Young Woo Lecturer,
More informationIntegrating Web-Based Technology in Distance Education for Nurses in China: Access and Attitudes to Computers and the Internet. C. E.
Integrating Web-Based Technology in Distance Education for Nurses in China: Access and Attitudes to Computers and the Internet Corresponding author: Betty Cragg Professor, School of Nursing University
More informationImpact of hospital nursing care on 30-day mortality for acute medical patients
JAN ORIGINAL RESEARCH Impact of hospital nursing care on 30-day mortality for acute medical patients Ann E. Tourangeau 1, Diane M. Doran 2, Linda McGillis Hall 3, Linda O Brien Pallas 4, Dorothy Pringle
More informationNurses' Job Satisfaction in Northwest Arkansas
University of Arkansas, Fayetteville ScholarWorks@UARK The Eleanor Mann School of Nursing Undergraduate Honors Theses The Eleanor Mann School of Nursing 5-2014 Nurses' Job Satisfaction in Northwest Arkansas
More informationText-based Document. Nursing Students' Perceptions of Satisfaction and Self- Confidence with High Fidelity Simulation. Authors Berkvam, Geraldine M.
The Henderson Repository is a free resource of the Honor Society of Nursing, Sigma Theta Tau International. It is dedicated to the dissemination of nursing research, researchrelated, and evidence-based
More informationMissed Nursing Care: Errors of Omission
Missed Nursing Care: Errors of Omission Beatrice Kalisch, PhD, RN, FAAN Titus Professor of Nursing and Chair University of Michigan Nursing Business and Health Systems Presented at the NDNQI annual meeting
More information10 Steps to Maximizing Nurses Full Scope of Practice Utilization in Primary Care Settings
10 Steps to Maximizing Nurses Full Scope of Practice Utilization in Primary Care Settings 1. Remember this will require understanding of the change process 2. Make a decision to become a nursing full scope
More informationImproving Nursing Workflow Efficiency & Nurses Knowledge & Attitude Toward Computers. WellStar Health System. Background
Improving Nursing Workflow Efficiency & Nurses Knowledge & Attitude Toward Computers LeeAnna Spiva, PhD, RN Patricia Hart, PhD, RN Sara Patrick, MSN, RN-BC Darcy Barrett, MSN, RN Erin Gallagher, BS Frank
More informationUNDERSTANDING DETERMINANTS OF OUTCOMES IN COMPLEX CONTINUING CARE
UNDERSTANDING DETERMINANTS OF OUTCOMES IN COMPLEX CONTINUING CARE FINAL REPORT DECEMBER 2008 CO PRINCIPAL INVESTIGATORS 1, 5, 6 Ann E. Tourangeau RN PhD Katherine McGilton RN PhD 2, 6 CO INVESTIGATORS
More informationThe Art and Science of Evidence-Based Decision-Making Epidemiology Can Help!
The Art and Science of Evidence-Based Decision-Making Epidemiology Can Help! Association of Public Health Epidemiologists in Ontario The Art and Science of Evidence-Based Decision-Making Epidemiology Can
More informationLiberating Restricted Visiting Policy in Greek Intensive Care Units: Is it that complicated?
Athanasiou A. RN, MSc 1 Papathanassoglou EDE. RN, MSc, PhD 2 Lemonidou C. RN, MSc, PhD 3 Patiraki E. RN, MSc, PhD 3 Giannakopoulou Μ. RN, PhD 3 1. ICU, 401 General Military Hospital of Athens 2. Cyprus
More informationRequired Competencies for Nurse Managers in Geriatric Care: The Viewpoint of Staff Nurses
International Journal of Caring Sciences September December 2016 Volume 9 Issue 3 Page 985 Original Article Required Competencies for Nurse Managers in Geriatric Care: The Viewpoint of Staff Nurses Ben
More informationA Study on AQ (Adversity Quotient), Job Satisfaction and Turnover Intention According to Work Units of Clinical Nursing Staffs in Korea
Indian Journal of Science and Technology, Vol 8(S8), 74-78, April 2015 ISSN (Print) : 0974-6846 ISSN (Online) : 0974-5645 DOI: 10.17485/ijst/2015/v8iS8/71503 A Study on AQ (Adversity Quotient), Job Satisfaction
More informationRunning Head: READINESS FOR DISCHARGE
Running Head: READINESS FOR DISCHARGE Readiness for Discharge Quantitative Review Melissa Benderman, Cynthia DeBoer, Patricia Kraemer, Barbara Van Der Male, & Angela VanMaanen. Ferris State University
More informationRNAO Delirium, Dementia, and Depression in Older Adults: Assessment and Care. Recommendation Comparison Chart
RNAO Delirium, Dementia, and Depression in Older Adults: Assessment and Care Recommendation Comparison Chart RECOMMENDATIONS FROM SCREENING FOR DELIRIUM, DEMENTIA AND DEPRESSION IN THE OLDER ADULT (2010)
More informationRapid Review Evidence Summary: Manual Double Checking August 2017
McGill University Health Centre: Nursing Research and MUHC Libraries What evidence exists that describes whether manual double checks should be performed independently or synchronously to decrease the
More informationFull-time Equivalents and Financial Costs Associated with Absenteeism, Overtime, and Involuntary Part-time Employment in the Nursing Profession
Full-time Equivalents and Financial Costs Associated with Absenteeism, Overtime, and Involuntary Part-time Employment in the Nursing Profession A Report prepared for the Canadian Nursing Advisory Committee
More informationDetermining Like Hospitals for Benchmarking Paper #2778
Determining Like Hospitals for Benchmarking Paper #2778 Diane Storer Brown, RN, PhD, FNAHQ, FAAN Kaiser Permanente Northern California, Oakland, CA, Nancy E. Donaldson, RN, DNSc, FAAN Department of Physiological
More informationRUNNING HEAD: SHARED GOVERNANCE IN A CLINIC SYSTEM Meyers 1. Shared Governance in a Clinic System
RUNNING HEAD: SHARED GOVERNANCE IN A CLINIC SYSTEM Meyers 1 Shared Governance in a Clinic System Michelle M. Meyers, RN, CCRN, DNP Student, Creighton University, 2500 California Plaza, Omaha NE 68102,
More informationCollaborative. Decision-making Framework: Quality Nursing Practice
Collaborative Decision-making Framework: Quality Nursing Practice SALPN, SRNA and RPNAS Councils Approval Effective Sept. 9, 2017 Please note: For consistency, when more than one regulatory body is being
More informationA Balanced Scorecard Approach to Determine Accreditation Measures with Clinical Governance Orientation: A Case Study of Sarem Women s Hospital
A Balanced Scorecard Approach to Determine Accreditation Measures with Clinical Governance Orientation: A Case Study of Sarem Women s Hospital Abbas Kazemi Islamic Azad University Sajjad Shokohyand Shahid
More informationNazan Yelkikalan, PhD Elif Yuzuak, MA Canakkale Onsekiz Mart University, Biga, Turkey
UDC: 334.722-055.2 THE FACTORS DETERMINING ENTREPRENEURSHIP TRENDS IN FEMALE UNIVERSITY STUDENTS: SAMPLE OF CANAKKALE ONSEKIZ MART UNIVERSITY BIGA FACULTY OF ECONOMICS AND ADMINISTRATIVE SCIENCES 1, (part
More informationText-based Document. Perceptions and Writing Experiences of Nursing Students: A Mixed Methods Exploration of Writing Self-Efficacy
The Henderson Repository is a free resource of the Honor Society of Nursing, Sigma Theta Tau International. It is dedicated to the dissemination of nursing research, researchrelated, and evidence-based
More informationHealthy workplaces from a perspective of Health Promoting Hospitals (HPH)
Healthy workplaces from a perspective of Health Promoting Hospitals (HPH) Jürgen M. Pelikan Professor em. for Sociology, University of Vienna, Austria Key Researcher, Ludwig Boltzmann Institute Health
More informationPatients satisfaction with mental health nursing interventions in the management of anxiety: Results of a questionnaire study.
d AUSTRALIAN CATHOLIC UNIVERSITY Patients satisfaction with mental health nursing interventions in the management of anxiety: Results of a questionnaire study. Sue Webster sue.webster@acu.edu.au 1 Background
More informationAssessing effective factors in development of entrepreneurship in agricultural cooperatives of Zanjan province
Available online at www.sciencedirect.com Procedia Social and Behavioral Sciences 15 (2011) 1521 1525 WCES-2011 Assessing effective factors in development of entrepreneurship in agricultural cooperatives
More informationSenior Nursing Students Perceptions of Patient Safety
Senior Nursing Students Perceptions of Patient Safety Dr. Cathleen Santos DNP, RN Curry College Milton, MA Problem Statement Patient safety is the most publicized issue facing the U.S. Healthcare system.
More informationInvited Speech: Evidence Based Practice: Acuity Based Care and Research Practice Change
Baptist Health South Florida Scholarly Commons @ Baptist Health South Florida All Publications 2014 Invited Speech: Evidence Based Practice: Acuity Based Care and Research Practice Change Carolyn Lindgren
More informationText-based Document. The Effect of a Workplace-Based Intervention on Moral Distress Among Registered Nurses. Powell, Nancy Miller
The Henderson Repository is a free resource of the Honor Society of Nursing, Sigma Theta Tau International. It is dedicated to the dissemination of nursing research, researchrelated, and evidence-based
More informationRelationship between Organizational Climate and Nurses Job Satisfaction in Bangladesh
Relationship between Organizational Climate and Nurses Job Satisfaction in Bangladesh Abdul Latif 1, Pratyanan Thiangchanya 2, Tasanee Nasae 3 1. Master in Nursing Administration Program, Faculty of Nursing,
More informationAmerican Board of Dental Examiners (ADEX) Clinical Licensure Examinations in Dental Hygiene. Technical Report Summary
American Board of Dental Examiners (ADEX) Clinical Licensure Examinations in Dental Hygiene Technical Report Summary October 16, 2017 Introduction Clinical examination programs serve a critical role in
More informationINDEPTH Scientific Conference, Addis Ababa, Ethiopia November 11 th -13 th, 2015
The relationships between structure, process and outcome as a measure of quality of care in the integrated chronic disease management model in rural South Africa INDEPTH Scientific Conference, Addis Ababa,
More informationQuality Improvement Plan
Quality Improvement Plan Agency Mission: The mission of MMSC Home Care Plus is to at all times render high quality, comprehensive, safe and cost-effective home health care and public health services to
More informationPatients preferences for nurses gender in Jordan
International Journal of Nursing Practice 2007; 13: 237 242 RESEARCH PAPER Patients preferences for nurses gender in Jordan Muayyad M Ahmad RN PhD Associate Professor, Faculty of Nursing, University of
More informationRisk Adjustment Methods in Value-Based Reimbursement Strategies
Paper 10621-2016 Risk Adjustment Methods in Value-Based Reimbursement Strategies ABSTRACT Daryl Wansink, PhD, Conifer Health Solutions, Inc. With the move to value-based benefit and reimbursement models,
More informationinternational journal of nursing sciences 2 (2015) 93e98 Available online at ScienceDirect
international journal of nursing sciences 2 (2015) 93e98 HOSTED BY Available online at www.sciencedirect.com ScienceDirect journal homepage: http://www.elsevier.com/journals/internationaljournal-of-nursing-sciences/2352-0132
More informationRESEARCH METHODOLOGY
Research Methodology 86 RESEARCH METHODOLOGY This chapter contains the detail of methodology selected by the researcher in order to assess the impact of health care provider participation in management
More informationConstruction and psychometric evaluation of the Swedish language Person-centred Climate Questionnaire staff version
Journal of Nursing Management, 2009, 17, 790 795 Construction and psychometric evaluation of the Swedish language Person-centred Climate Questionnaire staff version DAVID EDVARDSSON R N, P h D 1,2, P.O.
More informationDevelopment and Psychometric Testing of the Mariani Nursing Career Satisfaction Scale Bette Mariani, PhD, RN Villanova University
Development and Psychometric Testing of the Mariani Nursing Career Satisfaction Scale Bette Mariani, PhD, RN Villanova University Sigma Theta Tau International's 24th International Nursing Research Congress
More informationProceedings 59th ISI World Statistics Congress, August 2013, Hong Kong (Session CPS202) p.5309
Proceedings 59th ISI World Statistics Congress, 25-30 August 2013, Hong Kong (Session CPS202) p.5309 Statistical Analysis of Patients Satisfaction with Hospital Services: A Case Study of Shashemene and
More informationThe Control over Nursing Practice Scale: Reliability and Validity of the Turkish Version of the Instrument
International Journal of Caring Sciences May August 2017 Volume 10 Issue 2 Page 647 Original Article The Control over Nursing Practice Scale: Reliability and Validity of the Turkish Version of the Instrument
More informationThe Influence of Academic Organizational Climate on Nursing Faculty Members Commitment in Saudi Arabia
The Influence of Academic Organizational Climate on Nursing Faculty Members Commitment in Saudi Arabia Nazik M.A. Zakari King Saud University This study explored organizational climate and its effects
More informationAnalysis of Nursing Workload in Primary Care
Analysis of Nursing Workload in Primary Care University of Michigan Health System Final Report Client: Candia B. Laughlin, MS, RN Director of Nursing Ambulatory Care Coordinator: Laura Mittendorf Management
More informationRevista Publicando, 5 No 16. (1). 2018, ISSN
Studying the effect of systemic thinking and positive thinking on nursing decisionmaking processes in hospitals of Tehran University of Medical Sciences Nader Shahamat 1, Nazafarin Hosseini 2, Parvin Razmjooei
More informationNursing is a Team Sport
Nursing is a Team Sport Sideline Coaching to Achieve NCLEX-RN Success Tricia O Hara, PhD, RN Associate Professor Gwynedd Mercy University Gwynedd Valley, Pa, USA Purpose of the Study The primary purpose
More informationINDEPENDENT ASSESSMENT COMMITTEE REPORT SUMMARY
INDEPENDENT ASSESSMENT COMMITTEE REPORT SUMMARY Employer: Lakeridge Health Oshawa, Emergency Department (Oshawa Site) Board: Chair: Leslie Vincent; ONA Nominee: Cindy Gabrielli; Employer Nominee: Susan
More informationSouth Carolina Nursing Education Programs August, 2015 July 2016
South Carolina Nursing Education Programs August, 2015 July 2016 Acknowledgments This document was produced by the South Carolina Office for Healthcare Workforce in the South Carolina Area Health Education
More informationText-based Document. Implementing Strategies to Improve Patient Perception of Nursing Communication. Dunbar, Ghada; Nagar, Stacey
The Henderson Repository is a free resource of the Honor Society of Nursing, Sigma Theta Tau International. It is dedicated to the dissemination of nursing research, researchrelated, and evidence-based
More informationMassachusetts ICU Acuity Meeting
Massachusetts ICU Acuity Meeting Acuity Tool Certification and Reporting Requirements Acuity Tool Certification Template Suggested Guidance Acuity Tool Submission Details Submitting your acuity tool for
More informationCOMMUNITY HEALTH NEEDS ASSESSMENT HINDS, RANKIN, MADISON COUNTIES STATE OF MISSISSIPPI
COMMUNITY HEALTH NEEDS ASSESSMENT HINDS, RANKIN, MADISON COUNTIES STATE OF MISSISSIPPI Sample CHNA. This document is intended to be used as a reference only. Some information and data has been altered
More information2014 MASTER PROJECT LIST
Promoting Integrated Care for Dual Eligibles (PRIDE) This project addressed a set of organizational challenges that high performing plans must resolve in order to scale up to serve larger numbers of dual
More informationInstitute Presenters. Objectives: Participants Will Learn. Agenda 6/27/2014
Continuous Quality Improvement (): Assessing System of Care Implementation and Expansion Georgetown Training Institutes July 16 20, 2014 Washington, D.C. Funded by the Substance Abuse and Mental Health
More informationA Study on the Job Stress and Mental Health of Caregivers
, pp.226-230 http://dx.doi.org/10.14257/astl.2016.128.44 A Study on the Job Stress and Mental Health of Caregivers Joo Hee Han 1 and Eun Kwang Yoo 2 1 Department of Nursing, Hanyang University Hanyang
More informationSunrise Regional Health Authority
Sunrise Regional Health Authority Main points... 128 Background... 129 Audit objective, criteria, and conclusion... 130 Key findings and recommendations... 131 Set expectations that influence labour costs...
More informationPG snapshot Nursing Special Report. The Role of Workplace Safety and Surveillance Capacity in Driving Nurse and Patient Outcomes
PG snapshot news, views & ideas from the leader in healthcare experience & satisfaction measurement The Press Ganey snapshot is a monthly electronic bulletin freely available to all those involved or interested
More informationThe impact of nurses' empowerment and decision-making on the care quality of patients in healthcare reform plan
International Academic Institute for Science and Technology International Academic Journal of Organizational Behavior and Human Resource Management Vol. 2, No. 9, 2015, pp. 33-39. ISSN 2454-2210 International
More informationSURGEONS ATTITUDES TO TEAMWORK AND SAFETY
SURGEONS ATTITUDES TO TEAMWORK AND SAFETY Steven Yule 1, Rhona Flin 1, Simon Paterson-Brown 2 & Nikki Maran 3 1 Industrial Psychology Research Centre, University of Aberdeen, Aberdeen, Scotland, UK Departments
More informationCreating an Ohio Nurse Competency Model-Based RN Job Description Utilizing Delphi Methodology
Creating an Ohio Nurse Competency Model-Based RN Job Description Utilizing Delphi Methodology Lisa A. Aurilio, MSN, MBA, RN, NEA-BC Neil L. McNinch, MS, RN Eileen M. Zehe, MSN, RN, SPHR, SHRM-SCP The presenters
More informationSummary Report of Findings and Recommendations
Patient Experience Survey Study of Equivalency: Comparison of CG- CAHPS Visit Questions Added to the CG-CAHPS PCMH Survey Summary Report of Findings and Recommendations Submitted to: Minnesota Department
More informationInformation systems with electronic
Technology Innovations IT Sophistication and Quality Measures in Nursing Homes Gregory L. Alexander, PhD, RN; and Richard Madsen, PhD Abstract This study explores relationships between current levels of
More informationThe Evaluation of the Continuity of Care at the Group Health Centre, A Unique Multi-specialty, Multi-disciplinary Health Service Organization
The Evaluation of the Continuity of Care at the Group Health Centre, A Unique Multi-specialty, Multi-disciplinary Health Service Organization May 2006 Hui Lee, MD, FRCPC Lisa Dolovich, B.Sc.Phm., PharmD,
More informationNCLEX-RN 2015: Canadian Results. Published by the Canadian Council of Registered Nurse Regulators (CCRNR)
NCLEX-RN 2015: Canadian Results Published by the Canadian Council of Registered Nurse Regulators (CCRNR) March 31, 2016 Contents Message from the president 3 Background on the NCLEX-RN 4 The role of Canada
More informationLearning Activity: 1. Discuss identified gaps in the body of nurse work environment research.
Learning Activity: LEARNING OBJECTIVES 1. Discuss identified gaps in the body of nurse work environment research. EXPANDED CONTENT OUTLINE I. Nurse Work Environment Research a. Magnet Hospital Concept
More informationINSERT ORGANIZATION NAME
INSERT ORGANIZATION NAME Quality Management Program Description Insert Year SAMPLE-QMProgramDescriptionTemplate Page 1 of 13 Table of Contents I. Overview... Purpose Values Guiding Principles II. III.
More informationAssessment of Level 3 and Level 4 Nursing
Objectives Differentiate between the NI competency data subsets Describe the NI self-assessment tool development process Explore applications for level 3 and level 4 NI competencies self-assessment tool
More informationAdvancing Nursing Education Science: An Analysis of NLN's Grant Program
Marquette University e-publications@marquette College of Nursing Faculty Research and Publications Nursing, College of 1-1-2011 Advancing Nursing Education Science: An Analysis of NLN's Grant Program 2008-2010
More informationCritical Skills Needed: How IT Professionals Can Strengthen the Nursing Profession
Critical Skills Needed: How IT Professionals Can Strengthen the Nursing Profession Melinda McCannon, Ed.D Chair, Division of Business & Social Science Associate Professor of Business Gordon College 419
More informationType D Personality, Self-Resilience, and Health- Promoting Behaviors in Nursing Students
, pp.184-188 http://dx.doi.org/10.14257/astl.2015.116.37 Type D Personality, Self-Resilience, and Health- Promoting Behaviors in Nursing Students Eun Ju Lim RN PhD 1, Jun Hee Noh RN PhD 2, Yong Sun Jeong
More informationObjectives. Preparing Practice Scholars: Implementing Research in the DNP Curriculum. Introduction
Objectives Preparing Practice Scholars: Implementing Research in the DNP Curriculum 2011 Symposium Produced by Members of NONPF s Research SIG To discuss the levels of DNP research competencies currently
More information